A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later. 1. Introduction Ankylosing spondylitis (AS) is a chronic inflammatory disease, which can involve the spine and the sacroiliac joint. Its most common symptoms are chronic low back pain and morning stiffness. Leukocytoclastic vasculitis (LV) is a disease characterized by inflammation of small veins [1]. Its etiology includes various causes such as drugs, chemicals, infections, malignancies, lymphoproliferative disorders, connective tissue diseases, and systemic inflammatory diseases [2, 3]. However, the cause cannot be detected in some of the cases, and these cases are considered idiopathic cases [4, 5]. In practice, LV is a pathology commonly seen in connective tissue diseases and/or vasculitides. Studies have shown that there is a relation between WG, PAN, sarcoidosis and rheumatoid arthritis, and LV [6–8]. Blanco et al. have also shown that collagen tissue diseases are the most common causes of etiology of leukocytoclastic vasculitis [9]. The primary event in formation of pathogenesis of LV is formation of immune complex on the vein wall. The process, which starts when immune complexes activate the complement system, results in the damaging of vein walls by inflammatory cells [10]. Coexistence of ankylosing spondylitis and leukocytoclastic vasculitis is very rare and is limited to only a few case reports. In this document, we report a case of AS coexisting with leukocytoclastic vasculitis. 2. Case Report A 26-year-old male patient presented to our rheumatology
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